Training in pediatric psychology: a survey of predoctoral internship programs

OBJECTIVE: To describe internship training in pediatric psychology and to determine its correspondence with the recommendations of the Society of Pediatric Psychology (SPP) Task Force on Training. METHODS: A survey based on the Task Force recommendations was sent to all internship programs that reported offering a major rotation in pediatrics. RESULTS: Opportunities in a wide range of assessment and intervention strategies were available. Training in disease process, medical management, and consultation/liaison with a variety of disciplines was also offered. Interns interacted with individuals from a range of developmental stages and ethnicities. Many professional issues were addressed. Experiences in research methods and prevention were less well represented. CONCLUSIONS: Despite some variability, experiences in a wide range of areas were offered by many programs in several of the training domains recommended by the SPP Task Force. However, there is room for improvement in training in research and prevention and health promotion.     

Training graduate-level pediatric psychology researchers at Case Western Reserve University: meeting the challenges of the new millennium

OBJECTIVE: To describe the challenges in training graduate-level pediatric psychology researchers for successful careers and to discuss solutions. METHODS: We reviewed experiences in training graduate students at Case Western Reserve University to identify key challenges in research training and potential strategies to meet them. RESULTS: We identified the following key challenges: stimulating graduate students' career interest in pediatric psychology research; teaching students about the pragmatic challenges of conducting research in pediatric settings, specialized research design, and data analytic issues; helping students to develop essential research skills; developing opportunities for student research-related collaborations; helping students develop professional identities as researchers; and developing and supporting their research careers beyond graduate school. CONCLUSIONS: Useful strategies for meeting these challenges include involving an interdisciplinary faculty in research training; developing specialized training methods that focus on critical research skills such as writing and data analysis; peer support; and involvement with multiple mentors who are successful researchers. Pediatric psychologists should also develop opportunities for the next generation of researchers by facilitating research job options and leadership opportunities.     

Training experiences and theoretical orientations of pediatric psychologists

OBJECTIVE: To reexamine members of the Society of Pediatric Psychology (SPP) to document trends in training experiences of individuals who identify themselves as pediatric psychologists. METHODS: Using the 1999 SPP membership list, we asked respondents to complete a survey describing their degree status, theoretical orientation of graduate program, type of internship/fellowship, current employment setting, and orientation to assessment and treatment of pediatric problems. RESULTS: The majority of the respondents matriculated from doctoral programs in the last two decades. Compared to a previous survey (Mullins, Harbeck-Weber, Olson, & Hartman, 1996), this survey had a higher percentage of respondents who completed accredited predoctoral or postdoctoral training in pediatric psychology. Over half of the respondents were primarily employed in medical centers or academic institutions; fewer respondents reported working in private practice settings than in the previous survey 10 years ago. Respondents' current orientation was most often described as cognitive-behavioral. In this survey, the percentage of respondents endorsing an eclectic orientation was lower; the percentage endorsing cognitive-behavioral, behavioral, and systems orientations increased. CONCLUSIONS: We discuss implications of these findings as they relate to training and practice in pediatric psychology.     

A developmental history of the Society of Pediatric Psychology

Presented history of the field of pediatric psychology in general and, more specifically, the development of the Society of Pediatric Psychology. Review began with 1896 concepts of Lightner Witmer and followed with 1960 activities by Logan Wright which led to the formation of the Society. The developmental phases of the Society are described with respect to goals, publications, financial status, training issues, and awards established. Present activities of liaisons with numerous outside organizations and agencies and regional conferences are detailed.     

Pediatric Psychology Training: An Analysis of Graduate, Internship, and Postdoctoral Programs

The field of pediatric psychology is in the early stages offormulating its own identity relative to other areas, such asclinical child and health psychology. This paper complementsother recent efforts to delineate training practices and guidelines.Questionnaires regarding doctoral, internship, and postdoctoraltraining experiences were obtained from 89% of the membershipof the Society of Pediatric Psychology. From this information,rankings of the most commonly attended programs at each traininglevel were derived. Some overlap was apparent between doctoralprograms that were conducive to training in pediatric and clinicalchild psychology; however, differences between programs in theseareas also were noted. The most commonly attended internshipand postdoctoral settings were those in major medical centersor children's hospitals. Suggestions for investigating the currentstatus of predoctoral, internship, and postdoctoral programsthat may be facilitative of training in pediatric psychologyare discussed.     

Internship Programs Offering Clinical Experience With Children,Youth, and Families

A listing of internship programs offering clinical experience with children, youth, and families was compiled by obtaining information from all programs that listed such experiences in the current directory published by the Association of Psychology Internship Centers (APIC; 1985) and in the Directory of Internship Programs in Clinical Child and Pediatric Psychology (DIPCCPP; Tuma, 1986). This list provides a convenient source of information about available training experiences to interested students and faculty and is a first step in implementing the recommendations of the Hilton Head Conference on Training Clinical Child Psychologists as it pertains to internship training.     

Training in Pediatric Psychology: Survey Results and Recommendations

Little specific information is available on the types of experiencesthat are important for training in pediatric psychology. Toaddress this need, the membership of the Society of PediatricPsychology (SPP) was surveyed regarding their views on the structureand content of training. A total of 160 completed forms werereceived, representing a return rate of approximately 32%. Surveyresults suggested that training in pediatric psychology should(a) encompass course work and applied experiences in developmentaland clinical child psychology, behavioral assessment and intervention,and child health psychology; (b) move from broad-based activitiesoccurring early in graduate training, to more specialized experienceslater on (internship and postdoc); (c) consider viewing postdoctoraltraining as a necessary step in the preparation of pediatricpsychologists. Distinctions between pediatric psychology andclinical-child and health psychology are discussed with respectto training needs.     

Ethical beliefs and behaviors of pediatric psychologists: a survey.

There is an absence of data concerning the beliefs about and compliance with ethical principles of pediatric psychologists. Survey data were collected from 169 psychologist members of the Society of Pediatric Psychology (Division 12, Section 5 of APA) regarding the degree to which they engaged in each of 101 behaviors and the degree to which they considered each behavior ethical. The data were categorized and examined in terms of the APA Ethical Principles. Results indicated that pediatric psychologists show significantly different beliefs and behavior comparing children, adolescents, and their parents. A "majority belief" scale was developed where 80% of pediatric psychologists agreed that a clinical behavior was ethical or not ethical. Female pediatric psychologists, compared to males, more strongly endorsed the majority belief items (p less than .01). In addition, psychologists who graduated from APA-approved graduate programs more strongly endorsed the majority belief items than did psychologists from non-APA programs (p less than .05). Increased awareness of ethical issues is hoped to improve self-regulation by psychologists.     

Addressing the Needs: Guidelines for Training Psychologists to Work with Children,Youth, and Families

A need exists for criteria for training psychologists who work with children, youth, and families. Recognizing that the provision of competent services is directly related to training for those services, a set of recommendations was adopted by the Executive Committee of the Division on Child, Youth, and Family Services. This paper outlines these recommended experiences and coursework with their rationale for child development and lifespan developmental psychology, child and adult psychopathology, mental retardation and developmental disabilities; specialized child assessment techniques; child psychotherapy and behavior change; parent, family, and school intervention techniques; specialized clinical practice in child, parent, and family therapy; research methods in child psychology; ethics and legal issues related to children, youth, and families; and subspecialties within psychology for children, youth, and families. Examples of training programs meeting these recommended training criteria are discussed.     

Structural equation modeling in pediatric psychology: overview and review of applications

OBJECTIVE: To describe the use of structural equation modeling (SEM) in the Journal of Pediatric Psychology (JPP) and to discuss the usefulness of SEM applications in pediatric psychology research. METHOD: The use of SEM in JPP between 1997 and 2006 was examined and compared to leading journals in clinical psychology, clinical child psychology, and child development. RESULTS: SEM techniques were used in <4% of the empirical articles appearing in JPP between 1997 and 2006. SEM was used less frequently in JPP than in other clinically relevant journals over the past 10 years. However, results indicated a recent increase in JPP studies employing SEM techniques. CONCLUSIONS: SEM is an under-utilized class of techniques within pediatric psychology research, although investigations employing these methods are becoming more prevalent. Despite its infrequent use to date, SEM is a potentially useful tool for advancing pediatric psychology research with a number of advantages over traditional statistical methods.     

The Psychology Student Stress Questionnaire

Stressors of graduate psychology training remain relatively unexplored. The Psychology Student Stress Questionnaire (PSSQ) was developed to assess the impact of emotional, financial, and academic stressors of graduate psychology training on students. The PSSQ was administered, along with the Symptom Check List-90-R and the Health and Daily Living Form, to 133 graduate psychology students. Significant though limited correlations were obtained between the PSSQ and the two stress measures. Factor analysis of the PSSQ yielded seven underlying factors; time constraints accounted for the greatest variance in stress ratings. Female students had higher stress scores than males. These results suggest that the PSSQ could be useful in exploring student stress in graduate psychology training.     

Vale dictum: an editor's view of the field of pediatric psychology and its journal.

Examines activities of Editor of the Journal of Pediatric Psychology for issues published 1988-1992. Articles published during term are analyzed in terms of senior author gender, affiliation, academic rank, grant support, theoretical orientation, population type, population age, article type, and research purpose. Comparisons are made to earlier analysis of article trends in Journal by Elkins and Roberts (1988). A summary is provided of what the Journal reflects about pediatric psychology in terms of clinical practice, scientific research, and professional issues.     

Preparing psychologists to link systems of care in managing and preventing children's health problems

OBJECTIVE: To describe the need for innovations in training to link health, educational, and family systems and to illustrate how this can be accomplished through child-oriented psychology training programs. METHODS: We describe multiple pathways for the preparation of child-oriented psychologists to link health, educational, and family systems, in keeping with the National Institute of Mental Health guidelines for preparing professionals in child and adolescent psychology. These pathways include training embedded in graduate programs specializing in clinical child, pediatric, school, community, and family psychology. This article highlights a training initiative for preparing child-oriented psychologists based in a school psychology program. RESULTS: A partnership between Lehigh University and The Children's Hospital of Philadelphia has been developed to prepare school psychologists to coordinate community-based systems of care to promote positive educational and health outcomes for children. This program emphasizes both intervention and prevention and provides a set of integrated experiences in both health care and educational settings. CONCLUSIONS: We highlight components of this program relevant to the preparation of pediatric psychologists. We identify and discuss potential challenges in establishing training programs for the preparation of professionals to link health, school, and family systems.     

Family systems practice in pediatric psychology

OBJECTIVE: To present a pediatric psychology consultation treatment framework based on family systems and developmental theories. METHODS: After reviewing background relevant to family systems interventions, a five-step protocol (referral, assessment, collaboration, outcome) for consultation is presented, using case examples from our pediatric oncology service, to illustrate joining, focusing, promoting competence and collaboration with patients, families, and staff. RESULTS: Using protocols based on family systems frameworks, pediatric psychologists can offer systems-oriented consultation to patients, families, and healthcare teams. CONCLUSIONS: Further development and evaluation of family systems protocols are necessary to understand the efficacy of these approaches and their role in training and practice.     

ERRATUM

To the Editor: Please print a correction to my recently published article,"Postdoctoral Training Opportunities in Pediatric Psychology:A Review" (Journal of Pediatric Psychology, 1980, 5, 277–286).In that article, I referred to the postdoctoral training programin pediatric psychology at the University of Texas Medical Branchat Galveston as having been discontinued. Dr. Bill Caldwell,Director of that program, has recently assured me that suchreports are, happily, untrue. My coauthors and I were unableto reach Dr. Caldwell directly in the preparation of this review,and sincerely regret this error.     

Clinical psychology students' perceptions of diversity training: a study of exposure and satisfaction

This study examined clinical psychology graduate students' definitions of diversity and their perceptions of their exposure to and satisfaction regarding their level of diversity training. Four hundred and ninety‐one students from Counsel of University Directors of Clinical Psychology (CUDCP) member programs completed an online survey. Overall, students perceived that their programs considered diversity narrowly, concentrating primarily on ethnicity, race, and culture to the neglect of sexual orientation, religion, language, and physical disability. Likewise, students expressed greater satisfaction with training regarding ethnicity/race and gender than broader areas of diversity, but rated the importance of addressing all areas of diversity as high. Although this study underscores the limited experience that students perceive they have had with various underrepresented groups, programs appear to have incorporated a variety of diversity training modalities that could be expanded upon to meet the interests of psychology students. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65:1–15, 2009.     

Responding to Clinical Psychology Practicum Competencies: An APPIC Perspective

This article offers a commentary by representatives of the Association of Psychology Postdoctoral and Internship Centers (APPIC) on the 2015 article written by Gonsalvez et al. related to the assessment of clinical competencies in clinical psychology practicum students. The four competency “super clusters” derived by Gonsalvez et al. result from a unique empirical hierarchical clustering approach and are sure to add important knowledge to the field. This commentary generalizes from clinical psychology education and training in Australia to the United States, expands from practica to internship and postdoctoral training, and reflects on some relevant APPIC issues and initiatives. Future research is also suggested.     

Miniseries: broadening the scope of practice and research in pediatric psychology

Over the last several years, the scope of articles publishedin the Journal of Pediatric Psychology has expanded. Previously,most articles in the Journal involved chronic medical conditionssuch as cancer, sickle cell disease, and diabetes (B. Aylward,personal communication, March, 2007). However, more recently,two special issues of the journal related to environmental riskof children and adolescents, namely, tobacco and youth, andperinatal drug exposure, have been published. (JPP Vol. 30(4)2005 & JPP Vol. 31(1) 2006). The evolution in the expanded purview of pediatric psychologyis underscored further in the first chapter of     

Balancing Breadth and Specialized Training in Doctoral Education: (How) Can We Do It Effectively?

The existence and role of focused or specialized training experiences in doctoral training programs is an ongoing debate. Although accreditation guidelines specify that at the predoctoral level, training is broad and general, there is a diversity of opinion about the feasibility and wisdom of limiting predoctoral training to a broad and general level. Perry and Boccaccini (2009) present a study that documents the majority of accredited clinical psychology graduate programs self-identify on their websites as providing specialized training experiences and discusses several issues that this raises for the training community. This commentary adds to Perry and Boccaccini's thoughtful remarks by discussing implications of their data and the challenges that the clinical training community must address as active participants in the evolution of specialized training experiences in doctoral education.